1972434132 NPI number — HEZEKIAH ERNESTO NEGRETE LOPEZ

Table of content: HEZEKIAH ERNESTO NEGRETE LOPEZ (NPI 1972434132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972434132 NPI number — HEZEKIAH ERNESTO NEGRETE LOPEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEGRETE LOPEZ
Provider First Name:
HEZEKIAH
Provider Middle Name:
ERNESTO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972434132
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5601 ARNOLD RD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94568-7726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
833-599-2560
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5601 ARNOLD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94568-7724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-610-0580
Provider Business Practice Location Address Fax Number:
866-611-1558
Provider Enumeration Date:
05/27/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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